Lies, lies, and more lies – The Affordable Care Act
I think by now we all know that politicians exaggerate their own virtues and diminish and denigrate the accomplishments of their opponents. Donald Trump has taken this to a new level as a consummate BS artist; his lies are readily apparent and quite easily debunked for those who care to ascertain the truth.
Senator Vance is not Donald Trump and lacks his ability to BS; however he gave a polished and suave debate presentation, replete with lies from start to finish, showing off how to repeat Trump’s lies with the polished delivery developed as a Yale Law School graduate.
Let’s start with the Trump/Vance lies I know most about – the Affordable Care Act which now covers 45 million Americans. Vance said “Trump saved the law.” In fact, Trump as President sought repeatedly to repeal the Affordable Care, aka ObamaCare, in Congress finally failing on the Senate Floor when Senator John McCain dramatically gave a thumbs down. He and his legal allies in the Department of Justice sought to persuade the Supreme Court and lower courts to invalidate the ACA throughout his Presidency, failing in their final effort on a 7-2 vote by the Supreme Court, shortly after Trump left office. His Administration persistently over its 4 years in office sought to sabotage the program until his very last day in office. https://www.cbpp.org/sabotage-watch As just three examples, he cut the annual open enrollment period in half; he eliminated federal assistance to help people enroll in the new program; he eliminated the subsidies for insurance companies to reduce people’s out of pocket copays and deductibles. Biden reversed the Trump restrictions on the implementation of the ACA, increased the financial assistance to individuals and families purchasing through the state and federal Exchanges (Covered California in our state) and increased the financial assistance to the states to expand Medicaid for the uninsured.
As a result, the nation’s uninsured numbers and rates increased under Trump and fell under Biden. https://www.usatoday.com/story/money/2024/09/03/americans-without-health-insurance-under-trump-biden/75011896007/ In fact, the growth in enrollment in the ACA exchanges under Biden was fastest in the “red” states with high uninsured rates that had suffered the most from Trump policies to weaken and dismantle the ACA. https://www.kff.org/policy-watch/where-aca-marketplace-enrollment-is-growing-the-fastest-and-why/#:~:text=The%20five%20states%20with%20the,rolled%20out%2C%20they%20have%20not
The ACA’s expansion of coverage had two aspects: premium assistance through the Exchanges to help moderate- and middle-income Americans pay their share of premiums, copays and deductibles and Medicaid expansion to cover the lowest income uninsured Americans. The federal government pays 90% of the Medicaid expansion. Trump’s favorite Governors in the old Southern states from the Confederacy like Texas, Florida, Mississippi, Alabama and South Carolina have acted in concert with Trump to refuse to expand their state’s Medicaid programs to cover uninsured American citizens with incomes of less than 138% of the federal poverty level ($20,783 for an individual). https://www.kff.org/affordable-care-act/issue-brief/status-of-state-medicaid-expansion-decisions-interactive-map/
In states like Oklahoma, Idaho, South Dakota, Missouri, and Utah, the state’s voters adopted the Medicaid expansion by the initiative process after their Trump allied red state Governors and legislatures refused to act. https://www.kff.org/affordable-care-act/issue-brief/status-of-state-medicaid-expansion-decisions-interactive-map/ However, in a state like Florida where Trump lives and the Governor and GOP controlled legislature have chosen not to expand Medicaid, the current Medicaid income eligibility for a parent or parents with minor children living at home is 26% of the federal poverty level (FPL). Once their child turns 18, they are ineligible entirely. Texas has the highest uninsured rates in the nation – 18%, yet it’s GOP Governor and GOP dominated legislature have steadfastly refused to adopt the Medicaid expansion. https://covertexasnow.org/posts/2023/9/18/census-bureau-texas-has-worst-uninsured-rate-in-the-us
As of March 2024, over 45 million Americans have coverage through the Affordable Care Act (ACA), which is the highest number of people enrolled in ACA coverage on record. This is a 46% increase from 2021 (when Biden took office). https://www.hhs.gov/about/news/2024/03/22/celebration-10-years-aca-marketplaces-biden-harris-administration-releases-historic-enrollment-data.html
So to summarize, Trump tried to use Congress and the Courts to eliminate the ACA and tried to use his executive authority to weaken through executive orders and administrative rule making; he never used his bully pulpit to strengthen it, to persuade fellow GOP Governors, legislators or Congress to strengthen it. He failed. The Biden Administration used its executive and rulemaking authority to strengthen it; he worked with Congress to improve its affordability for consumers and the states. He succeeded.
The improved affordability of premiums and cost sharing in the Exchanges expires in 2025. Take a wild guess which candidate for President seeks to continue them.
References:
https://www.washingtonpost.com/politics/2024/10/02/fact-check-vp-debate-vance-walz/
https://www.npr.org/2024/10/02/nx-s1-5135675/jd-vance-tim-walz-vp-debate-fact-check
https://www.nytimes.com/live/2024/10/01/us/factcheck-walz-vance